Guest viewing is limited

THR Heterotopic Ossification

H

HOBooker3

new member
Joined
Jun 14, 2017
Messages
6
Age
70
Location
IN
Gender
Male
Country
United States United States
I had a THR in May 2016. There were bone spurs that had cut through my abductor muscle according to the surgeon. I do not have much range of motion in that hip after several attempts of PT. I had a good physical therapist but the heterotopic ossifications are growing in the front of my hip, the side of my hip, and the back of my hip. I have never had even 90° range of motion since the surgery.

Heterotopic ossification is when bone grows where it's not supposed to do in between the muscles, in the tissue.

It takes me several minutes to get in and out of the car. I walk with a limp. Since I cannot really bend over to pick something up or put on shoes etc. I tore my Achilles tendon in the other leg. I had one of the top orthopedic surgeons for hips in the country. There are classifications of HO from Booker 1 to 4. I am classified as a grade three.

The surgery to help range of motion is very difficult and there is commonly much loss of blood.

I am looking for a doctor that specializes in HO or alternative medicines. Also anybody that's had experience with this and would love to hear from you. Thank you
 
Yes, an oncologist surgeon would be the appropriate physician for you. It's is an extremely rare condition and I see that Horseshoe has already given you a link to my article.

Has your present surgeon tried to treat you with NSAIDs and/or radiotherapy? Those are the two usual treatments for it. I would advise against surgery until you have tried those as more surgery can cause more ossification.
 
My surgeon did recommend at least 1-2 months of NSAIDS before surgery. However, because I had several bleeds in my eye, the opthamologist had recommended not to take any NSAIDS at that point in time. The nurse that was explaining the protocol to us, regarding the THR and said that it was no big deal not to take the anti-inflammatory. Evidently, she had no idea why this is recommended. The doctor was very upset about this when he found out that I had not been on them, but that doesn't change the outcome. As soon as it was evident that I had HO, I was put on voltaren. I have been taking it for about 9 months with no adverse reactions. The surgeon said the radiotherapy does not help once the HO is there, but rather is done before the surgery. It has been 1 year since the surgery. The surgeon does not really recommend the surgery due to the fact that it will cause more of a limp, it's a Bloody surgery, and it can come back. He said I would gain ROM if I have the surgery. If I don't have it, he said that I will find other ways to sit, bend, pick up things etc. I have to an extent, but as I said before it caused me to tear my Achilles. No one can give me a good way to get up from a couch, etc. At any rate, I much less range of motion now, than I did before the surgery. Does anyone know of supplements or alternative medicines?

#heterotopicossification
 
HOBooker3 said:
However, because I had several bleeds in my eye, the opthamologist had recommended not to take any NSAIDS at that point in time.
Click to expand...
Ah! That's a good point.
HOBooker3 said:
The nurse that was explaining the protocol to us, regarding the THR and said that it was no big deal not to take the anti-inflammatory. Evidently, she had no idea why this is recommended.
Click to expand...
Evidently not!
HOBooker3 said:
I was put on voltaren
Click to expand...
Did you not know that Voltaton is diclofenac, an NSAID? And one of the more potent ones?
HOBooker3 said:
The surgeon said the radiotherapy does not help once the HO is there, but rather is done before the surgery.
Click to expand...
Quite so.
 
Hello:
I have Heterotopic Ossification in my left hip after total hip replacement 1 year ago. I was just told that the Orthopedic Surgeon believes that it has now matured. He also told me that the OH (webbed throughout hip muscles) is extensive and that he will not do any surgeries to remove it due to the risk of infection and that if he could do the surgery there is an 80% chance that it would come back much worse. I would lose a lot of blood
He also told me that this is as good as it is going to get.
I am a Maintenance Technician and my work is very physical. As a result of HO I have lost my job. I am very limited in movement, can't walk long distances, climb ladders, carrying any weight is extremely limited, can't bend to tie my shoes or cross my legs to put my socks on, can't kneel. Climbing stairs is difficult. I also use a walker when moving any distance and use a cane in my home. I have a great deal of pain as I try to accomplish work around the house. I had open heart surgery 4 years ago and my main heart valve is mechanical, so I have to take blood thinners every day. I had my left hip replaced back in 2002 with a lessor degree of HO.
The doctors are unwilling to subscribe the meds that work to control the pain, due to the Opioid crisis. I have been to two sets of Physical Therapists with no results about 30 times total.
Does anyone know of any specialists who deal with this condition in the Madison, WI area.
Thank You! Any help would be appreciated.
 
Last edited:
I just came back to this website to post an update about my wife who also has HO after her hip replacement last September 2016. You are the first person I have read about that also has this condition. I would love to hear from you. I found a doctor at Emory Orthopaedics Center in the Atlanta area who is a Musculoskeletal Oncology and has told us that he had done several operations to remove HO. His name is Dr. Shervin Oskouei. We have been waiting for the one year to be up to see if the calcium has quit growing. Today, Aug 22, 2017 we went to an imaging center here in Gainesville, GA and she had a full body scan including a 3D scan of the HO area on her right hip. We should know if it has in a couple of days. We really had planned on having the surgery because it doesn't seem she is going to get any better without it. I know the calcium can come back but we were advised she could have a treatment of radiation to help.

My wife is 69 and right now she has to use her rolling walker when she is out in public and she gets really tired very quickly. Around the house she can walk without the walker but again with a lot of pain. We live in Gainesville, GA. I would love to hear from you.
 
Last edited by a moderator:
Thank you for posting the articles and to members who have also given some helpful things to look at. Sometimes just reading about others in the same boat gives you hope. I see the dr in Chicago at the end of this week. I think the HO has stopped growing , but I'm not optimistic that he will have anything new to help or suggest.
I'm not sure about getting around this site too well, but the article that bikesouth looks interesting . Maybe will mention to dr. Still can't sit without leaning back, put on socks without a "sock helper" and have elastic shoelaces and long shoehorn to get shoe on without help. Some days even with these aids, I can't do it, so my wife does. We put a higher toilet which helps a little to get up from.
If anyone else has helpful hints, would love to hear them. Wishing you all the best.
 
HOBooker3, You are not alone. They are not many people who have this problem but there are some. My wife has the same problems that you do. She just had a NM full body scan at an imaging center here in our home town of Gainesville, GA. Her doctor ordered this scan right before her one year anniversary of having her hip replacement surgery. This will tell us if the calcium is still growing. If is not then we will think about the surgery to remove the HO. Lots of bad things to think about with this surgery but I can't see her getting a lot better without it. Let us know what your doctor has to say. My wife has the same problems with her socks and she has to use a rolling walker when she is out in public. Around the house she does OK without it or with her cane. However, she gets really tired easily and the HO causes her a lot of pain. My wife is 69.
 
This is a note to the imging center about the order my wife's doctor gave her for the NM Full Body Scan to see if the calcium is still active:


Attached Order Requisition for

Nuclear Medicine Whole Body Scan W/Spect

From: Dr. Shervin V. Oskouei,

Emory Orthopaedics Center/ Atlanta, GA


We would like to schedule this whole body scan for Anna on one of the following days: August 22/ 23/24, 2017. Anna would like to come in about 10AM to have the injection and then return 3 hours later (about 1PM) for the whole body scan. She has Heterotopic Ossification in her right hip/right leg.

It's called Nuclear Medicine because they inject a chemical that has a very small amount of radioactive medicine into her blood system and then she would come back for the full body scan three hours later. She did well with the scan which is a lot quicker and not noisy as an MRI. We will know by the end of this week the results.
 
HOBooker3, the name of the doctor I found who has advised us that he has done about 50 surgeries on people to remove the HO. He has been a doctor for over 17 years. His name is:
Dr. Shervin Oaskouei, Musculoskeletal Oncology, Emory Orthopaedics Center, Atlanta, GA. You can look at his history on Emory's website: www.emoryhealthcare.org/ If you are not familiar with Emory it is one of the leading Universities and Hospitals in the country (especially in the South it's Emory, Duke, Vanderbilt).

You were telling me things you have to help you with daily life. Here are some we have. The first is the adjustable toilet/commode, the name is Endurance HD Commode. Here is a photo:
 

Attachments

  • [Bonesmart.org] Heterotopic Ossification
    Endurance HD Commode.jpg
    48 KB · Views: 275
HOBooker3, My wife no longer uses the adjustable commode chair and now uses a riser which attaches to the top of her toilet (note we already had higher sized toilets). It comes with arms that attach to the size which she doesn't like and are not shown in the photo. The arms could help you get up from the toilet. Can't remember the name of the toilet riser but here is a photo:
 

Attachments

  • [Bonesmart.org] Heterotopic Ossification
    ToiletRiser.jpg
    68.6 KB · Views: 258
HOBooker3, At first my wife used a walker. The photo shows it with tennis balls attached to the bottom which works great in the house but not so great outside where concrete will eat up the tennis balls and they will have to be replaced. Here is a photo of her walker:
 

Attachments

  • [Bonesmart.org] Heterotopic Ossification
    Walker.jpg
    100.2 KB · Views: 221
HOBooker3, Now my wife uses a Rollator made by Drive (cost about $175). It has hand brakes which help when you are going down hill and the brakes can be locked. It's a lot easier to walk with that the regular walker. However, it has wheels all around so you have to take that in to consideration. Here is a photo: (Oh, it also has a little basket to help you carry a few items).
 

Attachments

  • [Bonesmart.org] Heterotopic Ossification
    Rollator.jpg
    78.6 KB · Views: 294
@CalciumHip
Thanks for the information and photos. I had the commode that sits on the toilet with arms also, but no longer use it. Our new ADA toilet sits next to a tile ledge so I am able to use that. I'm thinking if I need more , I could put some of those grab bars on each wall .
I'm thankful that I don't need a walker at this time. But it's good to have that information to reference later, if need be.
This doctor sounds terrific. Definitely something that I will save. Right now, I've decided not to have the surgery. My dr. Has said the revision surgery is a bloody surgery, where there is a lot of blood loss. There is also almost certainty that the HO will grow again. So I would continue taking the anti inflammatory before the surgery and they would radiate after surgery. My understanding is that it's a one time thing. My wife read an article in a medical journal that said there has been no one to date who has had any cancerous lesions grow due to this radiation treatment.
I don't know if I wrote this part or not before, but I would not have much abductor muscle left to stabilize my hip or have much strength in it.
I have been an insulin dependent diabetic since I was 21 years old, so healing is a little slower and more risk of infection . So for now, I'm putting the surgery off.
But think I will be looking into the doctor whose name you gave me. You never know... maybe he'll come up with some better kind of surgery or treatment.
Like you said, this affects such a small percentage of people so fewer grants are given for research. I think more monies are granted for those diseases that affect the masses, Unfortunately.
My doctor also had said that most HO bone matures by 1 year and then this past visit, changed his tune to " up to 2 years".
I was also told doing exercises in the water can help your balance, as well as your muscles and joints. A different doctor told me that some people have problems w balance after hip or knee replacement, which I do seem to be experiencing.
Has your wife had any trouble with her balance? Did they give her a level for her HO? Hope she continues to improve.
 
You are the first person we have heard from that also has HO. My wife had her left knee replaced on Aug 24, 2016 with the plan to rehab the left knee and then have the right one replaced maybe six months later. However, a week later she fell in our house and broke her right hip. She had to have a THP of the right hip on Sept 5, 2016. It seems that HO happens a lot with trauma, did you fall and break your hip? My wife is 69 and having a new knee and THP has been hard to rehab. Of course as soon as the HO developed her rehab became harder and harder. I was hoping the calcium would have stopped growing by the end of one year but it hasn't. I'm not really sure if it is getting bigger but it certainly is not getting smaller. At first the surgeon who did the THP told us that there was a good chance the HO would be reabsorbed by her body but then the doctor at Emory told us that usually doesn't happen. I was hoping that surgery would be the answer but the little info we have read about the surgery is not encouraging. My wife (Anna) has not been taking any medications for the HO. Her balance is a concern because she fell and broke her hip we can't take any chances of her falling again and breaking something else. The left knee that was replaced did not develop HO but the right hip she broke did. We are planning on visiting the doctor at Emory in September and I will update you on anything he tells us.
 
HOBooker3, Just wanted to check in with you to see how you are doing?? My wife is still having a lot of problems and pain.
 
You must log in or register to reply here.
Corganics CBD
Active Antimicrobial Hydrogel

Members online

No members online now.
Total: 531 (members: 0, guests: 531)

Latest posts

Back
Top Bottom